Course Handouts & Post Test

Size: px

Start display at page:

Download "Course Handouts & Post Test"

Arthur Daniels
5 years ago
Views:

Abuse, Neglect, Mistreatment and Exploitation What You Need to Know and Do Course Handouts & Post Test To download presentation handouts, click on the attachment icon Course evaluation

1 Abuse, Neglect, Mistreatment and Exploitation What You Need to Know and Do Course Handouts & Post Test To download presentation handouts, click on the attachment icon Course evaluation and post test are available from your course catalog To achieve credit for this course, close the video portion when completed and click on Start Test Know Warning Signs and Take Action 1

Describe hospice/palliative care specific factors that can lead to abuse, neglect, mistreatment, and/or

2 Course Objectives At the end of this course, participants will be able to: 1. Distinguish between different types of abuse and their warning signs. 2. Describe hospice/palliative care specific factors that can lead to abuse, neglect, mistreatment, and/or exploitation. 3. Describe actions for the hospice/palliative care team to take when abuse is suspected. As an adult learner What You Need to Know Definitions Warning Signs Who and Why 2

Abuse: Definition The willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish.

3 Abuse: Definition The willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. Willful Infliction (Intentional) Types of Abuse Physical Psychological/Emotional Sexual Verbal Neglect Exploitation Mistreatment Physical Abuse: Definition Includes, but is not limited to hitting, slapping, pinching and kicking. It also includes controlling behavior through corporal punishment. Harmful Physical Contact 3

Physical Abuse: Warning Signs Bruises (especially if on both sides of inner arms and thighs) Pressure marks Skin breakdown Broken bones Repeated falls Burns from hot water, cigarettes or ropes

Includes, but is not limited to humiliation, harassment, and threats of punishment or deprivation Anguish, Distress, Humiliation, Threats Psychological / Emotional Abuse: Warning Signs Reports or

4 Physical Abuse: Warning Signs Bruises (especially if on both sides of inner arms and thighs) Pressure marks Skin breakdown Broken bones Repeated falls Burns from hot water, cigarettes or ropes Inappropriate restraints Psychological / Emotional Abuse: Definition Inflicting mental pain, anguish, or distress on another through verbal or nonverbal acts. Includes, but is not limited to humiliation, harassment, and threats of punishment or deprivation Anguish, Distress, Humiliation, Threats Psychological / Emotional Abuse: Warning Signs Reports or experiences of belittling, threats Unexplained withdrawal from normal activities Sudden change in alertness Unusual depression Frightened, helpless or angry Patient has isolated from contact with others important to the patient (family, friends, doctor, clergy, IDG) 4

Sexual Abuse: Definition Includes, but is not limited to: sexual harassment, sexual coercion, sexual assault, non-consensual sexual contact of any kind.

5 Sexual Abuse: Definition Includes, but is not limited to: sexual harassment, sexual coercion, sexual assault, non-consensual sexual contact of any kind. Non-Consensual Sexual Contact Sexual Abuse: Warning Signs Bruises around the genitals, breasts Torn or bloody undergarments Frightened, withdrawn when personal care needs are tended Unusually withdrawn, hesitant to talk freely Verbal Abuse: Definition Includes the use of oral, written or gestured language that willfully includes disparaging and derogatory terms to patients or their families, or within their hearing distance, regardless of their age, ability to comprehend or disability. Key Words Verbal, Within Hearing Distance 5

Verbal Abuse: Warning Signs Verbal assaults, intimidation Strained or tense relationships Frequent arguments between the caregiver and the patient

care or protection for a vulnerable patient.

6 Verbal Abuse: Warning Signs Verbal assaults, intimidation Strained or tense relationships Frequent arguments between the caregiver and the patient Humiliating jokes or remarks about the patient Threats Neglect: Definition Refusal or failure by those responsible to provide food, shelter, health care or protection for a vulnerable patient. Failure To Do Good Neglect: Warning Signs Failure to assist in personal hygiene Failure to provide clothing and shelter Failure to provide medical care Failure to protect from health and safety hazards Failure to prevent malnutrition and dehydration Self-neglect 6

Mistreatment: Definition To treat someone or something roughly, wrongly or badly Treat Roughly, Wrongly, Badly Mistreatment: Warning Signs Demanding

through violence Caregiver history of coping through alcohol or drug dependency Exploitation: Definition Deliberate misplacement, concealment, or

7 Mistreatment: Definition To treat someone or something roughly, wrongly or badly Treat Roughly, Wrongly, Badly Mistreatment: Warning Signs Demanding that the patient does more than he can (like walking, eating) Not giving needed medications Overmedicating Be alert to Caregiver history of coping through violence Caregiver history of coping through alcohol or drug dependency Exploitation: Definition Deliberate misplacement, concealment, or wrongful, temporary or permanent use of a patient s belongings or money without the patient s consent. Misappropriation of patient property. Property, Belongings, Money 7

8 Exploitation: Warning Signs Missing possessions or money Unexplained loss of Social Security or pension checks Living conditions don t match the patient s financial situation Sudden inability to pay for food, health care, basic needs Inappropriate interest in the patient s assets Unusual changes to the patient s will, especially if the patient is confused Who are the abusers? Can be anyone Paid or volunteer caregivers Medical, long-term care, hospice employees Family members and significant others Acquaintances Strangers who ve befriend an elderly person for the purpose of exploiting them Why does abuse happen? Caregiver stress Frailty and vulnerability of end-of-life patient Dependency issues Mental decline Isolation Family conflict and stressful family events Family history of abusive behavior, alcohol or drug abuse, mental illness Neglect is most common abuse Financial exploitation is often the motivation for other kinds of abuse Relate these to hospice/palliative patients and caregivers needs! 8

What You Need to Do Multidisciplinary teams have been shown to be the most effective

Maya Jayawardena and Solomon Liao. Elder Abuse at End of Life.

) Assess, Educate, & Prevent Navigate needs with the persons involved Initial Assessment

9 What You Need to Do Multidisciplinary teams have been shown to be the most effective intervention for the assessment and prevention of abuse. K. Maya Jayawardena and Solomon Liao. Elder Abuse at End of Life. Journal of Palliative Medicine. February 2006, (1): ) Assess, Educate, & Prevent Navigate needs with the persons involved Initial Assessment Comprehensive Assessment Pre-death Bereavement Assessment Plan of Care Ongoing visits Patient/Family/Team Meetings Educate and support caregivers Be alert to warning signs Be alert. Be cautious. 9

Clarify what you see and experience Gather information Respond.

procedures Why? Because the patient s care is at stake.

10 Identify. Recognize signs Don t ignore Don t jump to conclusions Ask questions Clarify what you see and experience Gather information Respond. Immediately Contact your supervisor Follow your agency s policies and procedures Why? Because the patient s care is at stake. Because it s the law. Failure on the part of hospice personnel to report suspected abuse, neglect or exploitation results in disciplinary action and the potential for civil damages. 10

Sample Interventions Must be specific to the situation and persons Caregiver education and support Change caregiver Change to nursing facility

patient Agency s policies and procedures on abuse, neglect, mistreatment, and exploitation Interdisciplinary assessments with appropriate

11 Sample Interventions Must be specific to the situation and persons Caregiver education and support Change caregiver Change to nursing facility or inpatient care Investigation Adult Protective Services Employee discipline or termination Other A Surveyor Will Look For Quality care of the patient Agency s policies and procedures on abuse, neglect, mistreatment, and exploitation Interdisciplinary assessments with appropriate prevention, education, reporting, and intervention Put It In Action What I m already doing well: What I need to improve: My personal action plan: 11

12 Additional Resources National Adult Protective Services Association National Center on Elder Abuse Includes State Directory of Helplines, Hotlines, and Elder Abuse Prevention Resources Go to home page Select Find State Resources Select your state for a lists of Helplines, Hotlines, Referral sources Additional Resources continued National Committee on the Prevention of Elder Abuse (NCPEA), Caring for Seniors, Elder Care, Elder Abuse & Hospice, Free Law Resources, Nolo Elder Abuse: Financial Scams Against Seniors Elder Financial Abuse: Power of Attorney Scams Elder Abuse in Nursing Homes K. Maya Jayawardena and Solomon Liao. Elder Abuse at End of Life. Journal of Palliative Medicine. February 2006, (1): Course Handouts & Post Test Thank you for viewing this course on the Hospice Education Network The Course evaluation and post test are available from your course catalog page To achieve credit for this course, close the video portion when completed and click on Start Test 12

13 Abuse, Neglect, Mistreatment and Exploitation What You Need to Know and Do 13

Elder Abuse and Neglect Caregiving Series

Elder Abuse and Neglect Caregiving Series Objectives Upon completion of this program, the participant will learn: The definition, causes, and contributing risk factors of elder abuse The different forms